Claims Examiner job description template

This Claims Examiner job description template includes the list of most important Claims Examiner's duties and responsibilities. It is customizable and ready to post to job boards. Use it to save time, attract qualified candidates and hire best employees.

Claims Examiner job description template

Claims Examiner job profile

Generally, Claims Examiners are responsible for managing, investigating and processing of any claims a company receives. 

In order to attract Claims Examiner that best match your needs, it is very important to write a clear and precise Claims Examiner job description   

Claims Examiner job description

We are looking for a Claims Examiner to join our team. As the Claims Examiner in our company, you will be responsible for timely claims processing, adjudication, management and claim research.

In addition, you will have the opportunity to participate in enhancing claim processing procedures, audits, and special projects.

We are expecting you to be highly detail-oriented, precise, and to have the ability to initiate. 

Claims Examiner duties and responsibilities

  • Keep the department's claim inventory current and clear
  • Edit and adjust queues by process claims
  • Process claims according to verification of eligibility, interpretation of program benefits, and provider contracts 
  • Correctly match authorizations 
  • Coordinate benefits and other health coverage
  • Adhere to established standards 
  • Identify and report billing errors
  • Collaborate with team to improve processes

Claims Examiner requirements

  • Excellent ability to produce accurate and precise work in a fast-paced environment
  • A minimum of X years prior work experience in claims operations management
  • Hands-on working knowledge and background in claim processing
  • Good interpersonal and communication skills 
  • A high school diploma
  • College degree preferred

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